About six weeks before my 42nd birthday I went on a health checkup. Now, my normal attitude towards seeing the doctor is a variant of ”if it ain’t broken don’t fix it” so under normal circumstances I wouldn’t have gone. However, here in Taiwan, periodical checkups are mandatory under the labor law. For people my age it’s at least once every three years and I had already done one two years ago so I was planning to wait until next year. However, the company nurse informed me that the company was going to cover the, fairly significant, cost this year, but there was no guarantee they would pay next year. I can be a bit of a stubborn bastard, but under those circumstances even I could see the sense of going a year earlier than I’d originally planned.

The clinic I went to seems to be specialized in this kind of checkups because a small army of nearly identical nurses, grey uniform, ponytail, big round glasses, ushers patients from station to station in a calm but efficient manner. Height and weight measurement done, blood pressure check, done, there’s a queue at the eye exam so let’s do chest x-ray instead, and so on. Included on that list of checks is an abdominal ultrasound. The doctor had me lying down on an examination table, spread some gel onto my stomach then started sweeping the ultrasound probe across my skin. At one point on my right side he paused for a couple of moments then continued sweeping back and forth. When he had covered my whole stomach he went back to the point on my right side and focused in on it. I could see on the monitor above the examination table that he seemed to be making freeze frames – asking me to hold my breath each time – and making some kind of measurements. Eventually he gestured towards one of the indeterminate grey blobs among the other indeterminate grey blobs on the screen and told me it looked like a cyst on my right kidney, but it wasn’t, as he said, a ”true cyst” since it had some solid particles inside, whatever that meant. He advised me to get a CT scan and organized for the nurses at the front desk to book a time for me. He even referred me to a specific doctor.

I finished the health checkup in a state of mild confusion; what did he mean by ”not a true cyst”, did I need to be worried? Before I left, the nurses at the front desk booked a time for my follow-up appointment about two weeks later at one of the major hospitals in the city. I’m generally against googling your symptoms because since you’re not medically trained, you’re bound to misinterpret the information you find, but I couldn’t help myself. I needed to know what the doctor had meant. Apparently there are two types of renal cysts, the common ones which are benign, and the uncommon ones that can be malevolent. This of course has me a bit worried. That evening I told my wife and she, by some magic, managed to convince me not to worry,  and I put the whole thing out of my mind until the CT scan.

When I got to the hospital for my follow-up appointment, I quickly realized I had misunderstood something. I thought I would be doing the CT scan directly but when the nurse at the registration desk guided me to a waiting room full of people, I understood that this couldn’t be the case. By my estimate, there must have been around five or six doctors with their consultation rooms next to each other, and their patients all had to share one waiting area. It was complete chaos; probably 50 people or more, crammed into a room with about 20 seats, everyone milling around and getting into each other’s way, the poor nurses having to fend off people knocking on the door to ask “quick questions”. (Side note: I hate it when people ask me so called quick questions, because there’s rarely a quick answer.) By some miracle I managed to find a corner where I could at least lean against the wall while reading my book.

I waited for over an hour before being admitted into the consultation room. The doctor then spent all of 30 seconds looking at the ultrasound pictures from my health checkup before deciding that I did indeed need a CT scan. He booked the next available time for me, which happened to be in another branch of the same hospital corporation, then sent me on my way.

The day of the CT scan was rainy and miserable and I had to go to the hospital branch in the next town over. Luckily my wife had to attend some kind of meeting and didn’t need the car, so I could drive. I drove there in about 20 minutes then spent an additional 10 minutes trying to find a parking space. Once I succeeded with that, I immediately got lost looking for the CT scan lab. Eventually some kind of volunteer grandma showed me the way.

I’ve never had a CT scan before, but it was a mildly unsettling experience.  I had to lie on a sort of table in a kind of awkward position with my arms above my head and then get automatically fed into the actual scanner. All the while, a robotic voice kept telling me at intervals that I had to hold my breath or alternatively that I could relax. Perhaps the worst part was that they injected something called contrast fluid – I guess it’s a pigment that makes your organs show up more clearly on the scan – into my veins, and I have always been a bit afraid of needles. At least it was over fairly quickly and I could drive home in the rain.

The day after my CT scan was my birthday. I normally don’t put much effort into celebrating my birthday; the last significant milestone was when I turned 20 and I haven’t seen any reason for a big celebration since then. Anyway, this happened to be a Friday so I went to work like normal. That evening I had a wonderful birthday dinner with my wife and son. On Saturday some old friends had organized a little get-together in Taipei. We spent the evening drinking beer and chatting about everything under the sun. In my experience these get-togethers have a habit of ending after the buses and trains have stopped for the day so I had booked a cheap hotel. Sunday morning I took the train back home and when I walked through the door my wife and son surprised me with a home made birthday cake; probably the best surprise I’ve had in a long time. Though I didn’t do anything particularly exciting,  all those little things added up to a very pleasant birthday weekend.

On Monday morning it was time to check the results of my CT scan. The waiting room was less chaotic this time and I only waited a short while before being let in.  The doctor  looked at the CT scan images for a few moments then, in a matter-of-fact way, told me that the tumor is unlikely to be benevolent. At first I misheard, “likely benevolent?” I said with relief. “UN-likely” he corrected me and my heart sank. He explained that it looked like something called RCC then gave me the full name which I couldn’t quite understand. He then referred me to a urology specialist, and the visit was over.

As I was standing outside consultation room, waiting for the nurse to hand me the referral paperwork, I made the mistake of googling RCC. I realized that the name he had given that I didn’t understand was Renal Cell Carcinoma – a form of kidney cancer. When I read those words I started to panic; I felt like I was going to collapse right there in the busy waiting room. I quickly put my phone down and concentrated on breathing until the panic had passed. Thinking about it afterwards, it’s kind of strange that a doctor would tell you such a serious thing in such a straightforward manner, nothing to soften the emotional blow. Not to mention that in order for the hospital to run efficiently, they only gave me a few minutes for the entire visit.

When I got home I could finally let myself think and feel the things I’d been keeping out of my mind while at the hospital. A huge jumbled mess of semi-articulated thoughts and feelings came tumbling through my consciousness; I was sad and angry and scared, all at the same time. Chief among those thoughts was “Fuck me, I’m only 42 years old and now I’m gonna die from cancer,” everything else sort of followed from that. Of course, the doctor hadn’t actually said anything dramatic like that, he’d only given me a diagnosis and referred me to a specialist. On the other hand, everyone knows cancer is serious, so it’s hard not to worry when you’re told you have it. Something that struck me when I had calmed down a little bit was this: considering how close it was to my birthday, being informed I have cancer is probably the worst birthday present I can imagine; at least I got it a few days afterwards, so it didn’t ruin that wonderful weekend. 

Several weeks have passed since that horrible morning. I’ve had a consultation with a urologist who, in turn, referred me to his boss, the head of the urology department. He promised me he could perform a minimally invasive surgery, assisted by a robot (that’s pretty cool) to remove the tumor while leaving part of the kidney intact. And the fact is, RCC is usually discovered when symptoms occur, at which point the tumor has grown quite large. Thanks to the mandatory health checkup, they found it while it was still relatively small. All in all I find myself in a sort of best case scenario, given the circumstances. The surgery is in a few days, I’m considering to ask if I can get the tumor as a souvenir…so that I can set it on fire and then run it over with a truck.

One small note: for the sake of my mental health I’ve made an important distinction and it is this: I don’t have cancer, I have one single cancerous tumor. The difference is that, to my mind, cancer is this ominous thing that can spread through your body, while a single tumor can be removed.

Finally a message to the cancerous tumor in my kidney: I want to see my son grow up and you’re not going to stop me, so from the bottom of my heart: Fuck Off! Fuck off as far as it’s possible for anyone or anything to fuck off. Keep fucking off until you reach the end of the world, and when you get there, dare to do the impossible, and fuck off into eternity.